Patient Driven Grouping Models

The Centers for Medicare & Medicaid Services (CMS) announced a new home health payment reform plan effective January 1, 2020 that replaces a volume-based payment model with a value-based payment system. 

This model will focus on patient needs and rely more heavily on patient characteristics to pay for home health services.

EXPANSIVE PHYSICIAN ORDERS

Accommodate an unlimited number of secondary diagnosis codes, key for documenting comorbidities.

30 DAY PAMENT EPISODES

Careficient accommodates billing for 2 RAPs and 2 Final Claims per episode.

LUPA THRESHOLDS

LUPA logic changes in place, automatically calculate when patients fall under a LUPA based on HHRG and Clinical Groupings.

REIMBURSEMENT

Careficient accepts ERA from all MACs and easily posts them to patient invoices.

PDGM ANALYZER

Built in analyzer shows PDGM financial impact, projected reimbursements, and clinical groupings.

OASIS SUBMISSION AND VALIDATION

All necessary forms including OASIS – D updates are fully integrated with the system and are automatically generated and sent to the state for you.

INTEGRATED ELIGIBILITY VERIFICATION

Careficient verification fits seamlessly into your workflow process and automatically re-verifies for active patients.

DASHBOARDS / WHITE BOARD

Have all of your agency’s performance metric in key areas available right from one screen, including Financials, Census, Discharge, and Associate reporting.

Want to learn more on how Careficient can help with PDGM?

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Patient Driven Grouping Models

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